Is the advanced age a contraindication to GERD laparoscopic surgery? Results of a long term follow-up

摘要

In this prospective non randomized observational cohort study we haveevaluated the influence of age on outcome of laparoscopic totalfundoplication for GERD. Six hundred and twenty consecutive patients underwent total laparoscopicfundoplication for GERD. Five hundred and twenty-four patients were youngerthan 65 years (YG), and 96 patients were 65 years or older (EG). Thefollowing parameters were considered in the preoperative and postoperativeevaluation: presence, duration, and severity of GERD symptoms, presence of ahiatal hernia, manometric and 24 hour pH-monitoring data, duration ofoperation, incidence of complications and length of hospital stay. Elderly patients more often had atypical symptoms of GERD and at manometricevaluation had a higher rate of impaired esophageal peristalsis incomparison with younger patients. The duration of the operation was similarbetween the two groups. The incidence of intraoperative and postoperativecomplications was low and the difference was not statistically significantbetween the two groups. An excellent outcome was observed in 93.0% of youngpatients and in 88.9% of elderly patients (p = NS). Laparoscopic antireflux surgery is a safe and effective treatment for GERDeven in elderly patients, warranting low morbidity and mortality rates and asignificant improvement of symptoms comparable to younger patients.